<!DOCTYPE html>
<html>
<head>
<meta charset="UTF-8">
<title>Insert title here</title>
	<script type="text/javascript" src="../js/jquery-3.3.1.min.js"></script>
	<script type="text/javascript">
		$(document).ready(function(){
			$('#subbtn').click(function(){
				var name = $('#name').val();
				var phone = $('#phone').val();
				var emil = $('#emil').val();
				var emilNum = $('#emilNum').val();
				var address = $('#address').val();
				var rad = $('input:radio:checked').val();
// 				alert("name:"+name);
// 				alert("phone:"+phone);
// 				alert("emil:"+emil);
// 				alert("emilNum:"+emilNum);
// 				alert("rad:"+rad);
				$('#myform').submit();
			});	
		});
	</script>

</head>
<body>
<form id="myform" action="success.html">
	<p align="center">申诉单</p>
	<table width="1000" border="1" cellpadding="0" cellspacing="0" align="center" >
	  <tbody>
	    <tr>
	      <th scope="col"><table width="990" border="1" >
	        <tbody>
	          <tr>
	            <th width="200" align="center" style="font-size: 15px" scope="col">申诉人</th>
	            <th scope="col"><table width="790" border="1" cellpadding="0" cellspacing="0">
	              <tbody>
	                <tr> </tr>
	                </tbody>
	            </table>
	              <table width="790" border="1" cellpadding="0" cellspacing="0">
	                <tbody>
	                  <tr>
	                    <th scope="col" width="150" style="font-size: 15px">姓名（必须为申诉所涉及的号码机主姓名）&nbsp;</th>
	                    <th scope="col" width="250"><label for="textfield"></label>
	                      <input id="name" type="text" name="textfield" id="textfield"></th>
	                    <th scope="col" width="150" style="font-size: 15px">联系电话</th>
	                    <th scope="col" width="200"><label for="textfield2"></label>
	                      <input id="phone" type="text" name="textfield2" id="textfield2"></th>
	                  </tr>
	                  <tr>
	                    <td style="font-size: 15px">电子邮件</td>
	                    <td><label for="textfield3"></label>
	                      <input id="emil" type="text" name="textfield3" id="textfield3"></td>
	                    <td style="font-size: 15px">邮件编码</td>
	                    <td><label for="textfield4"></label>
	                      <input id="emilNum" type="text" name="textfield4" id="textfield4"></td>
	                  </tr>
	                </tbody>
	              </table>
	              <table width="750" border="1" cellpadding="0" cellspacing="0">
	                <tbody>
	                  <tr> </tr>
	                </tbody>
	              </table></th>
	          </tr>
	          <tr>
	            <td>被申诉人&nbsp;</td>
	            <td><table width="790" border="1" cellpadding="0" cellspacing="0">
	              <tbody>
	                <tr>
	                  <th scope="col" width="150" style="font-size: 15px">企业名称 </th>
	                  <th scope="col"><label for="select2"></label>
	                    <label for="select3"></label>
	                    <select name="select3" id="select3">
	                      <option>福州</option>
	                    </select>
	                    <select name="select2" id="select2">
	                      <option>鼓楼</option>
	                    </select>
	                    <label for="select"></label>
	                    <select name="select" id="select">
	                      <option>电信</option>
	                    </select></th>
	</tr>
	                <tr>
	                  <td width="150" style="font-size: 15px">通信地址</td>
	                  <td><label for="textfield5"></label>
	                    <input id="address" type="text" name="textfield5" id="textfield5" width="590"></td>
	</tr>
	              </tbody>
	            </table></td>
	          </tr>
	          <tr>
	            <td style="font-size: 15px">是否就申诉事项向被申诉人提出投诉</td>
	            <td><p>
	              <label>
	                <input type="radio" name="RadioGroup1" value="yes" id="RadioGroup1_0" style="font-size: 15px">
	                是</label>
	              <br>
	              <label>
	                <input type="radio" name="RadioGroup1" value="no" id="RadioGroup1_1" style="font-size: 15px">
	                否</label>
	              <br>
	              
	              <br>
	            </p>
	              
	          </tr>
	          <tr>
	            <td style="font-size: 15px">申诉内容&nbsp;</td>
	            <td><table width="790" border="1" cellpadding="0" cellspacing="0">
	              <tbody>
	                <tr>
	                  <th scope="col" width="150" style="font-size: 15px">申诉内容</th>
	                  <th scope="col" width="750"><label for="textarea"></label>
	                    <textarea name="textarea" id="textarea" >详见附件用户申诉信</textarea></th>
	                </tr>
	                <tr>
	                  <td width="150" style="font-size: 15px">申诉事实与理由</td>
	                  <td><label for="textarea2"></label>
	                    <textarea name="textarea2" id="textarea2">详见附件用户申诉信</textarea></td>
	                </tr>
	                <tr>
	                  <td width="150" style="font-size: 15px">申诉依据</td>
	                  <td><label for="textarea3"></label>
	                    <textarea name="textarea3" id="textarea3">详见附件用户申诉信</textarea></td>
	                </tr>
	              </tbody>
	            </table></td>
	          </tr>
	          <tr>
	            <td style="font-size: 15px">申诉来源</td>
	            <td><label for="select4"></label>
	              <select name="select4" id="select4">
	                <option>传真</option>
	            </select></td>
	          </tr>
	          <tr>
	            <td style="font-size: 15px">附件上传</td>
	            <td><label for="textfield6"></label>
	              <input type="text" name="textfield6" id="textfield6">
				  <input type="file" /><input type="button" value="添加附件"></td>
	          </tr>
	         
	        </tbody>
			  <table><input id="subbtn" type="button" value="提交" >
	      </table></th>
	    </tr>
	  </tbody>
	</table>
</form>
</body>
</html>